Hello everyone,
I’m a young adult residing in the United States who was recently diagnosed with polyarticular idiopathic arthritis. My life has been a hell of a rollercoaster since the diagnosis in December of 2020. Thankfully with the help of my care team, I’ve been almost symptom free for the past 3 months since I started Humira and Methotrexate (MTX). I’ve been on the MTX for almost 7 months now and Humira for around 4 months.
My rheumatologist recommended for me to switch to a medication called Cimzia which is also a TNF inhibitor. However, I would not have to take the MTX which ideal. I always have some fatigue, Nausea, and weakness the day after taking my MTX and has some lifestyle limitations such as no alcohol consumption. Switching over to Cimzia would both treat my condition and not require the use of MTX.
From an Insurance standpoint, I have not been able to get my medication approved. I’ve appealed Blue Cross Blue Shield but they have denied it since Humira is a preferred medication for them. The purpose of this post is that I would like to see what options I have available to get the Cimzia approved. I come from a lower income household and bought my Insurance through the healthcare marketplace. I will be starting graduate school soon which qualifies me to enroll during a period of non-enrollment for a new insurance provider.
*Also I understand that I am lucky to be where I’m at in terms of my prognosis, healthcare team, and treatment plan.*
submitted by /u/TrueLife101
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Hello everyone, I’m a young adult residing in the United States who was recently diagnosed with polyarticular idiopathic arthritis. My life has been a hell of a rollercoaster since the diagnosis in December of 2020. Thankfully with the help of my care team, I’ve been almost symptom free for the past 3 months since I started Humira and Methotrexate (MTX). I’ve been on the MTX for almost 7 months now and Humira for around 4 months. My rheumatologist recommended for me to switch to a medication called Cimzia which is also a TNF inhibitor. However, I would not have to take the MTX which ideal. I always have some fatigue, Nausea, and weakness the day after taking my MTX and has some lifestyle limitations such as no alcohol consumption. Switching over to Cimzia would both treat my condition and not require the use of MTX. From an Insurance standpoint, I have not been able to get my medication approved. I’ve appealed Blue Cross Blue Shield but they have denied it since Humira is a preferred medication for them. The purpose of this post is that I would like to see what options I have available to get the Cimzia approved. I come from a lower income household and bought my Insurance through the healthcare marketplace. I will be starting graduate school soon which qualifies me to enroll during a period of non-enrollment for a new insurance provider. *Also I understand that I am lucky to be where I’m at in terms of my prognosis, healthcare team, and treatment plan.*
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